Wondie Wubet Tazeb, Zemariam Alemu Birara, Gedefaw Gezahagn Demsu, Lakew Gebeyehu, Getachew Eyob, Mengistie Berihun Agegn, Shibabaw Adamu Ambachew, Chereka Alex Ayenew, Kitil Gemeda Wakgari, Yirsaw Amlaku Nigusie, Mekonnen Gebrehiwot Berie
Department of Pediatrics and Child Health Nursing, College of Health Sciences and Referral Hospital, Ambo University, Ambo, Ethiopia.
Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Science Woldia University, Woldia, Ethiopia.
Front Public Health. 2025 Apr 8;13:1496931. doi: 10.3389/fpubh.2025.1496931. eCollection 2025.
Vitamin A supplementation is a key strategy for preventing the consequences of vitamin A deficiency and childhood illnesses, notably in countries where vitamin A deficiency is a public health issue. However, studies in Ethiopia are inconsistent. Hence, this meta-analysis assessed coverage of vitamin A supplementation and associated factors among children aged 6-59 months in Ethiopia.
A search of articles from databases (PubMed, Science Direct, African Index Medicus, and HINARI), and search engines (Google Scholar, Google, and Worldwide Science) was done. All observational studies that report vitamin A supplementation and/or associated factors among children were included. The Joana Brigs quality appraisal checklist was used. To estimate the pooled effect size a random effect model was used. Heterogeneity was evaluated using -test and Cochrane Q statistics. Subgroup and sensitivity analyses were conducted. Publication bias was assessed using Egger's test and funnel plot.
A total of 14 studies, involving 43,047 children aged 6-59 months, were included. The pooled vitamin A supplementation coverage was 54.88% (95% CI: 47.34-62.42). The lowest coverage 43.71%% (95% CI: 42.71-45.14) was among children 6-35 months. Four or more antenatal care (AOR: 1.79, 95%CI: 1.59-2.01), Postnatal care (AOR: 1.43, 95% CI: 1.24-1.66), delivery at health facilities (AOR: 1.14 95%CI: 1.02-1.28), media exposure (AOR: 1.19, 95% CI: 1.08-1.31), time to reach health facilities (AOR: 1.90, 95% CI: 1.11-3.24), information about VAS (AOR: 2.99, 95%CI: 1.72-5.20), maternal secondary education and above (AOR: 1.32, 95% CI: 1.07-1.64), and (AOR: 2.31, 95% CI: 1.31-4.09) respectively, and fathers education above secondary school (AOR:1.92, 95% CI: 1.13-3.26) were significant factors.
The pooled vitamin A supplementation coverage is significantly below the WHO's recommendation of 80%. Antenatal care, postnatal care, health facilities delivery, media exposure, time to reach health facilities, Information about VAS, maternal and paternal secondary education, and above increase VAS. Hence, the national nutritional program is better to increase awareness of the community about VAS, particularly targeting parents with low educational status and no antenatal and postnatal care through social media and community meetings. Additionally, the EPI program should strengthen outreach supplementations including door-to-door distribution to address older children and socio-economically disadvantaged populations.
identifier CRD42024576200.
补充维生素A是预防维生素A缺乏后果和儿童疾病的关键策略，特别是在维生素A缺乏成为公共卫生问题的国家。然而，埃塞俄比亚的相关研究结果并不一致。因此，本荟萃分析评估了埃塞俄比亚6至59个月儿童补充维生素A的覆盖率及相关因素。
检索了数据库（PubMed、Science Direct、非洲医学索引和HINARI）以及搜索引擎（谷歌学术、谷歌和世界科学）中的文章。纳入所有报告儿童补充维生素A和/或相关因素的观察性研究。使用了乔安娜·布里格斯质量评估清单。采用随机效应模型估计合并效应量。使用卡方检验和Cochrane Q统计量评估异质性。进行了亚组分析和敏感性分析。使用Egger检验和漏斗图评估发表偏倚。
共纳入14项研究，涉及43047名6至59个月的儿童。维生素A补充的合并覆盖率为54.88%（95%置信区间：47.34 - 62.42）。6至35个月儿童的覆盖率最低，为43.71%（95%置信区间：42.71 - 45.14）。四次及以上产前检查（调整后比值比：1.79，95%置信区间：1.59 - 2.01）、产后护理（调整后比值比：1.43，95%置信区间：1.24 - 1.66）、在医疗机构分娩（调整后比值比：1.14，95%置信区间：1.02 - 1.28）、接触媒体（调整后比值比：1.19，95%置信区间：1.08 - 1.31）、到达医疗机构的时间（调整后比值比：1.90，95%置信区间：1.11 - 3.24）、关于维生素A补充的信息（调整后比值比：2.99，95%置信区间：1.72 - 5.20）、母亲接受过中等及以上教育（调整后比值比：1.32，95%置信区间：1.07 - 1.64）以及父亲接受过中等及以上教育（调整后比值比：1.92，95%置信区间：1.13 - 3.26）分别是显著因素。
维生素A补充的合并覆盖率显著低于世界卫生组织80%的建议。产前检查、产后护理、在医疗机构分娩、接触媒体、到达医疗机构的时间、关于维生素A补充的信息、母亲和父亲的中等及以上教育水平会增加维生素A补充率。因此，国家营养计划最好通过社交媒体和社区会议提高社区对维生素A补充的认识，特别是针对教育程度低且未接受产前和产后护理的父母。此外，扩大免疫规划（EPI）应加强外展补充工作，包括挨家挨户分发，以覆盖年龄较大的儿童和社会经济弱势人群。
标识符CRD42024576200。
